HomeMy WebLinkAboutX2021-1636 - Permit ApplicationF- Comm'I r Residential
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City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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(-Drainage [Elec F-,iMech Plum cuvdCut F Cu yd Fill v
Project Address (Not mailing address) F_ Flood r'-' Fire F- Liq r Landslide CN/A Floor Suite No
Description of Work
IN D y 6 '
Use F— ConstType�
# Storiesr� # Units (if Resf —
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Valuation $
Material/Labor
New/Add SFr. _
Remodel SFF— Garage/New/Add
OWNER'S NAME
Last � First
C
Owner's Address
Owner's E-mail Address
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City IAWII�i
9 State Zip Telephone
APPLICANT'S NAME
Last �C, First L % L✓
Applicant's Address
Applicant's E-mail Address
City
_.. State---.-.-- Zip TelephoneF
ARCHITECT/DESIGNER'S NAME Last -- First Lic. No. ` [z —
Architect/Designer's Address
Architect/Designer's E-mail Address
City
ON SATURDAYS
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_ State Zip Telephoner
ENGINEER'S NAME
G ' s
LastLic No.
First
skv pis �s G,11:0:2
Engineer's Address
Engineer's E-mail Address
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City / ✓�{.�-�
FA
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State Zip �� Telephone i1/�-f� 77
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CONTRACTOR'SNAMEXOMPANY Lic./No./
Contractor's Address
Contractor's E-mail Address V���Sl
City �—
State F Zip Telephoner--.-.--
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.1/ 00 ® O li
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $